Book contents
- International Compendium of Movement Disorders
- International Compendium of Movement Disorders
- Copyright page
- Contents
- Contributors
- International Compendium of Movement Disorders
- Hypo- and Hyperkinetic, Dyscoordinative and Otherwise Inappropriate Motor and Behavioral Movement Disorders
- Section 1: Basic Introduction
- Section 2: Hypokinetic Movement Disorders
- Chapter 12 Autonomic Dysfunction in Parkinson’s Disease
- Chapter 13 Neuropsychiatric Manifestations in Parkinson Disease
- Chapter 14 Sleep–Wake Disorders in Parkinson’s Disease
- Chapter 15 Neuronal Activity in the Basal Ganglia and Thalamus in Patients with Parkinson’s Disease
- Chapter 16 Pathology in Parkinson’s Disease
- Chapter 17 Diagnosis of Parkinson’s Disease
- Chapter 18 Prodromal Manifestations of Parkinson’s Disease
- Chapter 19 Biomarkers in Parkinson’s Disease
- Chapter 20 Physical Rehabilitation of Patients with Parkinson’s Disease
- Chapter 21 Regenerative Strategies for Parkinson’s Disease
- Chapter 22 Conventional Pharmacotherapy in Parkinson’s Disease
- Chapter 23 Continuous Dopaminergic Stimulation in Parkinson’s Disease
- Chapter 24 Pipeline of Pharmacotherapy in Parkinson’s Disease
- Chapter 25 Non-Invasive Brain Stimulation for the Treatment of Parkinson’s Disease
- Chapter 26 Deep Brain Stimulation in Parkinson’s Disease
- Chapter 27 Focused Ultrasound in Parkinson’s Disease
- Chapter 28 Dementia with Lewy Bodies
- Chapter 29 Genetic Parkinsonisms
- Chapter 30 Multiple System Atrophy
- Chapter 31 Progressive Supranuclear Palsy
- Chapter 32 Corticobasal Degeneration and Corticobasal Syndrome
- Chapter 33 Other Tau-Related Parkinsonisms
- Chapter 34 Vascular Parkinsonism
- Chapter 35 Illicit Drug–Induced Parkinsonism
- Section 3: Hyperkinetic Movement Disorders
- Section 4: Dyscoordinative and Otherwise Inappropriate Motor Behaviors
- Section 5: Objectifying Movement Disorders
- Movement Disorders in Vivo: Video Fragments
- Acronyms and Abbreviations
- Index
- References
Chapter 23 - Continuous Dopaminergic Stimulation in Parkinson’s Disease
from Section 2: - Hypokinetic Movement Disorders
Published online by Cambridge University Press: 07 January 2025
- International Compendium of Movement Disorders
- International Compendium of Movement Disorders
- Copyright page
- Contents
- Contributors
- International Compendium of Movement Disorders
- Hypo- and Hyperkinetic, Dyscoordinative and Otherwise Inappropriate Motor and Behavioral Movement Disorders
- Section 1: Basic Introduction
- Section 2: Hypokinetic Movement Disorders
- Chapter 12 Autonomic Dysfunction in Parkinson’s Disease
- Chapter 13 Neuropsychiatric Manifestations in Parkinson Disease
- Chapter 14 Sleep–Wake Disorders in Parkinson’s Disease
- Chapter 15 Neuronal Activity in the Basal Ganglia and Thalamus in Patients with Parkinson’s Disease
- Chapter 16 Pathology in Parkinson’s Disease
- Chapter 17 Diagnosis of Parkinson’s Disease
- Chapter 18 Prodromal Manifestations of Parkinson’s Disease
- Chapter 19 Biomarkers in Parkinson’s Disease
- Chapter 20 Physical Rehabilitation of Patients with Parkinson’s Disease
- Chapter 21 Regenerative Strategies for Parkinson’s Disease
- Chapter 22 Conventional Pharmacotherapy in Parkinson’s Disease
- Chapter 23 Continuous Dopaminergic Stimulation in Parkinson’s Disease
- Chapter 24 Pipeline of Pharmacotherapy in Parkinson’s Disease
- Chapter 25 Non-Invasive Brain Stimulation for the Treatment of Parkinson’s Disease
- Chapter 26 Deep Brain Stimulation in Parkinson’s Disease
- Chapter 27 Focused Ultrasound in Parkinson’s Disease
- Chapter 28 Dementia with Lewy Bodies
- Chapter 29 Genetic Parkinsonisms
- Chapter 30 Multiple System Atrophy
- Chapter 31 Progressive Supranuclear Palsy
- Chapter 32 Corticobasal Degeneration and Corticobasal Syndrome
- Chapter 33 Other Tau-Related Parkinsonisms
- Chapter 34 Vascular Parkinsonism
- Chapter 35 Illicit Drug–Induced Parkinsonism
- Section 3: Hyperkinetic Movement Disorders
- Section 4: Dyscoordinative and Otherwise Inappropriate Motor Behaviors
- Section 5: Objectifying Movement Disorders
- Movement Disorders in Vivo: Video Fragments
- Acronyms and Abbreviations
- Index
- References
Summary
Continuous dopaminergic stimulation aims to avoid fluctuations in plasma levels of antiparkinsonian drugs in Parkinson’s disease. There are limited possibilities for translating this concept into practice with standard oral therapies: subcutaneous infusions of apomorphine (and in the near future most probably also of levodopa) and intestinal infusions of levodopa/carbidopa (LD/CD). Both allow the maintenance of stable drug levels in blood and hence a sustained stimulation of dopamine receptors. The magnitude of the effect is more or less similar between techniques, with a reduction in OFF time, an improvement in ON time, and at least for infusions of LD/CD, documented reduction in dyskinesias. The effect is apparently greater with the intestinal and subcutaneous levodopa infusions given that they were compared with oral LD/CD in their pivotal studies whereas apomorphine was compared with placebo. As of yet, subcutaneous apomorphine and intestinal LD/CD infusions are positioned at the same level of efficacy as surgical treatment of PD and are alternatives for the treatment of patients with motor fluctuations not controlled with conventional treatment.
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- International Compendium of Movement Disorders , pp. 280 - 289Publisher: Cambridge University PressPrint publication year: 2025